SEC Form 4 · accession 0001127602-17-014066
CVS HEALTH Corp · CVS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Lisa Bisaccia
Officer — EVP and Chief HR Officer
Period of report
Apr 1, 2017
Accepted (ET)
Apr 4, 2017 · 5:43 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000064803
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Apr 1, 2017 | F | 1,291 | $78.50 | D | 46,863 | D | |
| Common StockF1 | Apr 2, 2017 | F | 1,862 | $78.50 | D | 45,001 | D | |
| Common Stock (restricted)F2 | Apr 3, 2017 | A | 7,046 | $78.05 | A | 23,084 | D | |
| ESOP Common Stock | holding | — | — | — | 577 | I | Direct | |
| Stock Unit | holding | — | — | — | 35,098 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock OptionF3 | $78.05 | Apr 3, 2017 | A | 55,098 | A | Apr 3, 2018 | Apr 3, 2024 | Common Stock | 55,098 | 55,098 | D |
| Phantom Stock CreditsF4 | $1.00 | holding | — | — | — | — | — | Common Stock | 468 | 468 | D |
| Stock OptionF5 | $45.07 | holding | — | — | — | Apr 2, 2013 | Apr 2, 2019 | Common Stock | 7,764 | 7,764 | D |
| Stock OptionF6 | $54.53 | holding | — | — | — | Apr 1, 2014 | Apr 1, 2020 | Common Stock | 13,770 | 13,770 | D |
| Stock OptionF7 | $74.29 | holding | — | — | — | Apr 1, 2015 | Apr 1, 2021 | Common Stock | 25,177 | 25,177 | D |
| Stock OptionF8 | $102.26 | holding | — | — | — | Apr 1, 2016 | Apr 1, 2022 | Common Stock | 34,241 | 34,241 | D |
| Stock OptionF9 | $104.82 | holding | — | — | — | Apr 1, 2017 | Apr 1, 2023 | Common Stock | 39,433 | 39,433 | D |
Explanation of responses
- F1Surrender of shares in payment of withholding taxes due upon the vesting of a restricted stock unit award.
- F2Consists of restricted stock units awarded pursuant to Issuer's 2010 Incentive Compensation Plan. Restrictions lapse 50% on 4/3/2020 and 50% on 4/3/2022.
- F3Option becomes exercisable in four equal annual installments, commencing 4/3/2018.
- F4Reflects year-end company-match share credits under a non-qualified deferred compensation plan; share credits are payable in cash only, as such time as has been elected by the reporting person.
- F5Option became exercisable in four equal annual installments, commencing 4/2/2013.
- F6Option became exercisable in four equal annual installments, commencing 4/1/2014.
- F7Option became exercisable in four equal annual installments, commencing 4/1/2015.
- F8Option became exercisable in four equal annual installments, commencing 4/1/2016.
- F9Option became exercisable in four equal annual installments, commencing 4/1/2017.